Critical care medicine
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Critical care medicine · May 1990
Efficacy of large-bore intravenous fluid administration sets designed for rapid volume resuscitation.
We tested the hypothesis that large-bore iv tubing sets provide greater in vitro flow rates than conventional sets currently utilized for the administration of normal saline. The study was conducted in two parts. First, flow rates were measured using a conventional iv tubing set under gravity and 300 mm Hg of pressure, and four large-bore iv tubing sets under gravity. ⋯ Mean time necessary for the 28 anesthesiology staff and residents to pressurize and deflate a conventional tubing set was 65 sec/bag of packed RBC. We conclude that a considerable amount of time can be saved by utilizing large-bore iv tubing sets instead of conventional pressurized sets during massive volume resuscitation. Clinical trials are indicated to corroborate these results.
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Critical care medicine · May 1990
Case ReportsThird-degree burns from the use of an external cardiac pacing device.
Noninvasive external cardiac pacing has been used safely in various cardiac emergencies for over 30 yr. Its use in neonates, however, has been associated recently with burns. We report the case of a 7-wk-old infant who sustained a full-thickness burn after prolonged use of an external pacing device.
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Critical care medicine · May 1990
Influence of parenteral nutrition on rates of net substrate oxidation in severe trauma patients.
Optimal nutritional support should use a patient's energy expenditure as a guide for administering sufficient but not excessive caloric intake. Eight patients requiring parenteral nutrition were evaluated, using indirect calorimetry measurements, to determine the nutritional influence on the rates of substrate utilization in the critical period of catabolic illness due to accidental trauma. ⋯ The results suggest that positive energy balance could be achieved in trauma patients by providing total energy intake matching their basal measured energy expenditure plus 7% to 10% for activity energy expenditure. To prevent further loss of lean body mass, an N intake of 350 mg/kg.day was needed in these catabolic ICU patients.
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Critical care medicine · Apr 1990
Editorial CommentColloid versus crystalloid war--a time for truce.